腹腔镜术治疗中叶突出前列腺癌20例报告

Laparoscopic radical prostatectomy for large median lobes:report of 20 cases

目的:介绍腹腔镜术治疗中叶突出前列腺癌的临床经验。方法:采用腹腔镜下前列腺癌根治术治疗中叶突进膀胱三角区的前列腺癌患者20例,其中8例中叶突出2cm以内的患者直接贴腺体切开膀胱后壁;12例中叶突出超过2cm的患者先横行切开中叶表面黏膜,潜行分离并剥出中叶后再行横断膀胱后壁。结果:20例手术均获得成功,平均手术时间135min,术中出血量350ml,1例直肠前壁损伤,平均留置尿管15.7天,术后1年控尿率90%。结论:腹腔镜下前列腺癌根治术适用于中叶突出的前列腺癌,但术中有效地处理中叶是关键。

Objective： To recommend our experiences of laparoscopic radical prostatectomy for large median lobes. Method：Between May 2003 and September 2011, 20 localized prostate cancer patients with large median lobes underwent Laparoseopie radical prostatectomy. Among them, 8 cases with a protrusion less than 2 centimeters underwent dissection posterior wall of bladder along the base of median lobes; and 12 cases protrusion more than 2 centimeters underwent a dissection begins along the anterior portion of the vesicoprostatic junction trans- versely, then across the mucosa of the median lobe and developed the plane inferiorly before dissect the posterior wall of bladder. Result：Operative time ranged from 80 to 170 min, Intraoperative blood lose were about 100 to 900 ml, 1 case had a rupture in anterior wall of rectum and repaired intraoperative, Mean catheterization time 14 to 20 days, The continence rate was 90% 1 year postoperative. Conclusion： Laparoseopie radical prostatectomy is an ef fective and safe surgery for large median lobes, to deal with median lobes efficiently is the key point.